Nursing 163-Unit 1 Perioperative Nursing Exam Questions with Latest Update
3 views 0 purchase
Course
NUR 163
Institution
NUR 163
The Case - Answer-John Egan, 53, has a history of type 1 diabetes, cigarette smoking 40 pack years, CAD, and PVD. Six weeks ago, he developed a wound of his left heel which measured 4 cm by 2 cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene i...
Nursing 163-Unit 1 Perioperative
Nursing Exam Questions with Latest
Update
The Case - Answer-John Egan, 53, has a history of type 1 diabetes, cigarette smoking
40 pack years, CAD, and PVD. Six weeks ago, he developed a wound of his left heel
which measured 4 cm by 2 cm when he discovered it. Despite IV antibiotics and
chemical debridement, the wound developed a gangrene infection. He is scheduled for
a BKA of the left lower extremity tomorrow at 10 am. His meds include daily insulin,
aspirin 325 mg/day, Pletal 100mg BID. He has advanced directives and NKDA.
Identify the priority nursing care for Mr. Egan - Answer--complete pre-operative
testing/preparation
-maintain normal glucose levels
-ensure informed consent
-ensure correct surgical site
-prevent post-op infections
-complete pre-operative teaching to prevent complications
-address psychological comfort
Pre-surgical screening tests - Answer--chest x-ray
-EKG for >40 yrs
-complete blood count
-electrolyte levels
-urinalysis
-x-ray left lower extremity
When completing a medication reconciliation for Mr Egan the evening before surgery,
which orders increase the nurse's concern? - Answer--Insulin 6 units regular with 15
units NPH subq every am
-aspirin 325 mg PO q.d.
-Pletal 100 mg PO BID
-ativan 0.5 mg IVP on call to OR in AM
Red Rule - Answer-Patient Safety Alert
Red Letter Rule #3
Medications
When administering medications, the medication administration record (MAR) and the
medication in the original packet or unit dose must be brought to the patient's bedside
The following steps must occur
, Verify patient ID using 2 different identifiers (neither to be the patient's room)-resolve
discrepancies before administering medication
Ensure compliance with the 5 rights of Medication Administration
-the right patient
-the right drug
-the right dose
-the right route
-the right time
Validate with another RN a documented double-check for all insulin, heparin, warfarin,
and narcotic medications prior to the administration of the medication
NO EXCEPTIONS TO THIS RULE
Informed Consent for Surgery and Blood Transfusion - Answer-3 requirements:
-Adequate disclosure of diagnosis-purpose, risks, and consequences of treatment,
probability of success, prognosis if not instituted
-understanding and comprehension-patient must be drug free prior to signing consent
-consent given voluntarily-patient must not be persuaded or coerced to undergo
procedure
Informed Consent Information - Answer--Description of procedure and alternative
therapies
-Underlying disease process and its natural course
-Name and qualifications of person performing procedure
-Explanation of risks and how often they occur
-Explanation that the patient has the right to refuse treatment or withdraw consent
-Explanation of expected outcome, recovery, rehabilitation plan, and course of
treatment
-Patient must be 18 years old to sign own consent or be an emancipated minor
-patients signs for dependent children as legally responsible
-patient must be deemed competent to sign own consent
-patient must be alert and orientated; consent may not be signed by patient after
receiving narcotics or sedatives
-not necessary if threat to life and patient or legally authorized person unavailable
Informed Consent for Surgery, Anesthesia, & Blood Transfusion - Answer--Part of legal
preparation for surgery
-Active, shared decision making process between provider and recipient of care
-Protects patient, surgeon, hospital and its employees
-Nurses role: advocate, witness, appropriate person signs
-Medical emergency and consent-2 physicians write it is necessary in chart
Advanced Directives - Answer-Living Wills
-patient is usually a full code for 24 hours following surgery
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller lectknancy. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.49. You're not tied to anything after your purchase.
